Is endoscopic retrograde appendicitis therapy a better modality for acute uncomplicated appendicitis? A systematic review and metaanalysis

作     者：Ying Wang Chen-Yu Sun Jie Liu Yue Chen Chandur Bhan John Pocholo Whitaker Tuason Sudha Misra Yu-Ting Huang Shao-Di Ma Xing-Yu Cheng Qin Zhou Wen-Chao Gu Dan-Dan Wu Xia Chen 

作者机构：Department of Endoscopy CenterThe First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina Internal MedicineAMITA Health Saint Joseph Hospital ChicagoChicagoIL 60657United States Department of GastroenterologyThe First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina Department of Clinical MedicineSchool of the First Clinical MedicineAnhui Medical UniversityHefei 230032Anhui ProvinceChina University of Maryland Medical Center Midtown CampusBaltimoreMD 21201United States Department of Epidemiology and Health StatisticsSchool of Public Health Anhui Medical UniversityHefei 230032Anhui ProvinceChina Department of Radiation OncologyMayo ClinicRochesterMN 55905United States Department of Diagnostic Radiology and Nuclear MedicineGunma University Graduate School of MedicineMaebashi 371-8511Japan Department of NursingThe First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2021年第9卷第33期

页      面：10208-10221页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Endoscopic retrograde appendicitis therapy Acute appendicitis Meta analysis Laparoscopic appendectomy Randomized controlled study 

摘      要：BACKGROUND Previous studies had shown endoscopic retrograde appendicitis therapy(ERAT)is an effective treatment for acute ***,different studies reported conflicting outcomes regarding the effectiveness of ERAT in comparison with laparoscopic appendectomy(LA).AIM To compare the effectiveness of ERAT with *** Randomized controlled trials(RCTs)and retrospective studies of ERAT for acute uncomplicated appendicitis were searched in PubMed,Cochrane Library,Web of Science,Embase database,China National Knowledge Infrastructure(CNKI),the WanFang Database,and Chinese Scientific Journals Database(VIP)from the establishment date to March *** was assessed using the Isquared *** odds ratios(OR),weighted mean difference(WMD),and standard mean difference(SMD),with 95%confidence intervals(CI)were calculated through either fixed-effects or random-effects *** analysis was also *** bias was tested by Egger s test,and Begg’s *** quality of included RCT were evaluated by the Jadad scale,while Newcastle-Ottawa scale is adopted for assessing the methodological quality of case-control *** statistical analysis was performed using Stata 15.1 statistical *** statistical analysis was performed using Stata 15.1 statistical *** study is registered with PROSPERO,*** After screening,10 RCTs and 2 case-control studies were included in the current systematic ***,the length of hospitalizations[WMD=-1.15,95%CI:-1.99,-0.31;P=0.007]was shorter than LA ***,the level of postoperative CRP[WMD=-10.06,95%CI:(-17.39,-2.73);P=0.007],TNF-α[WMD=-7.70,95%CI:(-8.47,-6.93);P0.001],and IL-6 Levels[WMD=-9.78,95%CI:(-10.69,-8.88);P0.001;P0.001]in ERAT group was significantly lower than LA ***,ERAT group had a lower incidence of intestinal obstruction than LA group.[OR=0.19,95%CI:(0.05,0.79);P=0.020].Moreover,the quality of 10 RCTs were low with 0-3 J